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Stage 4 Pancreatic Cancer

If you’ve been diagnosed with pancreatic cancer, your doctor
will first want to find out what stage cancer you have. Staging helps your
doctor design the best treatment course. The stage tells whether the cancer has
spread within your body, and if so, where it’s located.

Pancreatic cancer is often diagnosed at a late stage because
it tends not to show symptoms early on. Stage 4 pancreatic cancer means the
cancer has spread to other organs, typically the liver or the lungs. You can’t
cure the cancer at this point, but you still have treatment options.

It’s important to understand what treatments are available
to you, so you can make the right decisions.

Treatments You Can Try

For stage 4 cancer, your doctor might recommend one or more
of the following treatments:

Chemotherapy.
This treatment uses drugs that kill cancer cells or stop them from dividing. Chemotherapy
is given either by a pill or intravenously through a vein.

Gemcitabine (brand name: Gemzar) is the most commonly used drug
for late-stage pancreatic cancer. You may get this drug alone, or combined with
other drugs such as albumin-bound paclitaxel (Abraxane), erlotinib (Tarceva),
or capecitabine (Xeloda). Chemotherapy may also be given in combination with
radiation (this is called chemoradiation), a procedure that kills cancer cells
with high-energy rays. Some common side effects are hair loss, fatigue, and
increased risk for infection.

Palliative pain
treatments. As your tumor grows, it can put pressure on nearby nerves and
organs. This can cause pain and discomfort. Your doctor might give you an
injection of pain medicine, or cut the nerves that are causing the pain
sensation. This treatment doesn’t cure the cancer, but it can make you feel
more comfortable.

Palliative surgery.
Surgery at this stage can’t remove the cancer, because it has spread too far.
However, it can relieve any blockages the tumor has created. There are three
kinds of surgery that may be done for stage 4 pancreatic cancer:

Bypass
surgery is an option if the tumor is blocking the common bile duct. The
liver normally releases a substance called bile, which helps with digestion.
Bile is stored in the gallbladder. It then travels through the common bile duct
to the intestines. From there, it’s removed from the body in the stool. When a
tumor blocks the small intestine, bile can build up in the body and cause jaundice,
which is the yellowing of the skin and eyes. Bypass surgery connects the bile
duct or gallbladder directly to the small intestine to get around the blockage;
this procedure is known as a choledochojejunostomy.

A stent is a thin metal tube that’s placed inside the blocked bile duct to
open it up so that bile can drain. The bile may drain to the outside of the
body, or into the small intestine. A stent can also be used to keep the small
intestine open if the cancer is blocking it. You may need to have another
surgery to place a new stent after a few months since the tumor can eventually
grow and block the stent.

Gastric
bypass is surgery that attaches
the stomach directly to the small intestine. It can be used to circumvent a
tumor that’s blocking food from leaving your stomach (referred to as gastric
outlet obstruction) and reaching your intestine.

When Treatments Stop Working

The available treatments for stage 4 cancer generally won’t
stop your cancer from growing. But don’t give up hope if your doctor says there
are no other treatments left to try. Researchers are testing new cancer
therapies in clinical trials.

When you enroll in one of these trials, you’ll have a chance
to test a new treatment that isn’t yet available to the general public. The
study you’re in might eventually lead to a new breakthrough therapy for
pancreatic cancer.

Ask your doctor
about clinical trials, or look for open trials online.

Getting treatment for a late-stage cancer can be confusing
and stressful. If you start to feel overwhelmed, ask your medical team, family,
friends, and counselors for help and support.